Have you or a loved one had tests, surgeries, procedures or medications that you thought were unnecessary? If so, we would like to hear your story. We'd also like to know if you declined tests or treatments offered to you that you thought were unnecessary and found a medically appropriate alternative. Thanks for taking the time to do this. Your personal experience can really help us stop unnecessary and inappropriate medical care in the future, and improve the quality of care for patients.
One of the the areas in which medical overtreatment is done most is in maternity care. Its a multi-billion dollar business where each delivery costs almost triple than it otherwise could. There is evidence to suggest that childbirth in a hospital after a low-risk is overtreatment. Midwives are able to safely assist women in birthing their babies in their homes in the vast majority of pregnancies at the fraction of the cost. Choosing to birth without a medical attendant is also a valid option given preparation, planning and access to emergency services.
If you, one of my readers, have a story to tell about unnecessary medical treatment during your child's pregnancy, labor and birth, the Consumer's Union Safe Patient Project is giving you the opportunity to tell about your experiences. If your experiences were traumatic reporting on it may be triggering. There is a chance that your story will make a difference in maternity care and you'll face better and more appropriate treatment the next time you have a baby. You may also be making maternity care better for other mothers and their babies. The URL for the survey is: http://cu.convio.net/site/PageServer?pagename=spp_unnecessary_care
The following is the story I told. I'm including my responses to the question. I tried to explain as clearly as I could that I feel like the admission to the hospital in early labor was medical overtreatment. I recognize that in the big picture and in comparison to other birth experiences I may have had, its a small thing. But as I learned, it can and did have strong consequences.
1. Question - What type of medical overtreatment did you experience?
Answered: Other
2. Question - In what kind of facility did the event occur?
Answered: Hospital
3. Question - Describe your medical overtreatment experience in your own words (the space below allows you to include as much detail as you like):
I was admitted to the hospital in early labor (38 weeks pregnant) where the midwives proceeded to attempt a induction. This strategy is sometimes called a "backdoor induction" because it misleads the pregnant patient into believing that her labor is more progressed than reality and that a hospital admission is warranted. In response to this question, I'm considering the hospital admission medical overtreatment. There was no need to be admitted to the hospital at that time. The result of the admission was stress in response to the coercion used by the midwife on duty who attempted to get me to consent to an induction that was unnecessary. I felt bullied, manipulated and scared for my health and my unborn baby. I experienced PTSD as a result from what I feel like was fighting off a potential rape of my body.
4. Question - Did you report this incident to your state's Medical Board or other licensing agency?
Answered: Yes
5. Question - If yes, what was the Medical Board or Licensing Agency response?
Answered: None
6. Question - Your experience or that of a loved one resulted in:
Answered: minor injury or minor disabling condition
7. Additional Comments:
I explained above that I experienced PTSD as a result of overtreatment in my pregnancy. Often the psychological response is not classed as "morbidity" but considering how debilitating it was for me, I consider it a minor condition that had far reaching effects on my life. I still suffer the effects of the emotional trauma but felt recovered enough to not longer need treatment after 1 year.
8. Question - If you or your loved one experienced medical harm from overuse, how long did it take to fully recover from the incident?
Answered: More than a year
9. Question - Did the medical professional fully inform you of the risks of the procedure or treatment.
Answered: Did not provide full information about the risks
10. Question - Please describe additional information that you received about the risk or found out after the procedure from another source.
I was not informed that the risk of early admission to the hospital was increased intervention that could lead to a hasty attempt at induction which is associated with a higher likelihood of c-section, mortality for mother and baby, respiratory distress for the baby and NICU stay. If I had know that quickly, upon admission to the hospital that an induction of active labor would have been suggested, I would not have consented to being admitted.
It was later that I found out about backdoor induction from a labor and delivery nurse who blogged about it at:http://nursingbirth.com/2009/04/13/don%E2%80%99t-let-this-happen-to-you-24-part-1-of-2-jessica-jason%E2%80%99s-back-door-induction/
11. Question - Were there unanticipated costs associated with the medical procedure or treatment?
Answered: Yes (therapy, an extra day of hospitalization)
12. Question - Did your health insurance company pay for expenses associated with this care?
Answered: No (not the therapy)
13. Question - If you declined medical care you thought was unnecessary, what tests or treatments were offered to you that you declined?
Answered: Other
14. Question - Please describe why you thought the tests or treatment were unnecessary and declined them.
I declined the induction that the midwife attempted to force on me. She lied to me telling that she wanted to augment my labor. I after learned that using pitocin and breaking water before 4 cm dilation (and active labor) is a complete induction.
I also declined the morphine and sleep aids that I was offered. I felt that the midwife was attempting to coerce to me take them and that she did it with the intent of knocking me out so she wouldn't have to deal with me. When a woman is coping well with her established labor pattern and is not expressing any exhaustion or discomfort, the offer for pain relief or sleep aid is unnecessary.
15. Did you seek a second opinion?
Answered: Yes
16. Question - What did you do?
Answered: Pursued another treatment
17. Additional Information:
Because I was told that there was a good reason to be admitted to the hospital, I was very confused why I was then rudely told to leave the hospital when I declined the offered procedures and drugs. I continued laboring and progressed to active labor after being kicked out of the hospital for my lack of cooperation. I was then afraid of going back to the hospital fearing that I would be told to leave again, forced into intervention I knew to be unnecessary or that I would be lied to regarding the health and well-being of my baby.
In the hospital, I considered trying to switch providers to one of the OBs on staff and I learned that the OB supported and was going to sustain the midwife's plan for my labor. When I was told that I would not consent, the OB told me to leave.
At home I considered the options of not seeking further treatment or consulting with another hospital or maternity care provider. Because I was in labor and the baby would be born within hours, I could not bring myself to go to a different hospital and provider that I had not planned on working with. I was very fearful that if I even tried another hospital would not admit me. That left my other option of giving birth at home unattended by a medical professional or calling a homebirth midwife to attend me which I did not think a midwife would be willing to do without a prior working relationship with me. I was worried about the legal implications of birthing unassisted and thought perhaps my child could be taken away from me because of my neglect is obtaining proper medical attendance for his birth. I felt like my only option was to return to the hospital where I had been treated badly and hope for the best in spite of my fear.
Upon returning to the hospital, labor progressed easily and I birthed my baby unmedicated and without further intervention within 6 hours. By that time the midwife who had troubled me the day before was off shift and I didn't have to deal with her anymore. No further attempts to alter my labor were made though AROM was done with my consent. It was unnecessary at the time too but I did consent to it and did not feel pressured to do so.
In effect, the treatment I pursued was "the tincture of time." I knew that a first time labor could be slow to establish an active labor pattern that with the supportive emotional and physical assistance I could bear the labor as it progressed and that in time, the baby would be born without difficulty.
My story does not highlight the most egregious ethical lapses of a maternity care provider but yet, her treatment and tactics still were not right, not in line with the midwifery model of care and unfortunately indicative of the greater obstetric culture where its just fine for providers to withhold and manipulate information to hurry births along. I can only speculate on the motivations for why they do it and even with an explanation, the "care" cannot be excused. I truly hope that my story and others will have an impact on how patients are treated and that they are given the respect they deserve to make completely informed decisions.
11 comments:
I do understand that what you went through was uncomfortable, but comparing it to rape is unjustifiable. In the end you had a choice whether or not the doctor would treat you. During rape your choice to say no is muffled and taken away. It is not simply unsatisfactory, it is a full on physical invasion...not just a concept you can easily decline. With all do respect, I understand the need for sharp words in order to embellish a story, however as a victim of rape, and a person who also experienced unfortunate treatment during both labor and a surgery, the two experiences don't even begin to compare. I hope that you are recovering well from your uncomfortable,unsatisfactory experience. I mean you no disrespect, just don't make comparisons to experiences you've seemingly never had (or you would not have made the comparison). God Bless
Anonymous,
Actually "birth rape" is a fairly common term for the loss of power and autonomy during birth. Just because a doctor or midwife or nurse has "noble" intentions does not mean a mother was not assaulted. And some procedures in birth involve penetration and if the mother felt out of control or did not give consent, then I do feel that "rape" is an appropriate term. Jenne's birth experience wasn't simply "uncomfortable"- there were lasting emotional effects. I know moms who have experienced PTSD from birth experiences- and while I'm not qualified to say that's what Jenne experienced, what she went through should not be discounted.
I wish we could have discussed this yesterday in more detail. Yes, I'm a man, but I was there at the births of all 4 of our children.
Just because a doctor or midwife or nurse has "noble" intentions does not mean a mother was not assaulted.
I felt some like punching the one Dr. who did the episotomy, without any pain killers (!), at one of the births! Even *if* it's supposed to be numb from pushing, I could tell it still hurt!
Perhaps when used in this context, the phrase "birthrape" should be used instead of the term "rape" as the two are drastically different. Being held down, muffled physically, and invaded by a a penis (or any other phallic-type object), is far different than what Jenne describes repeatedly as the potential fate of her birth story. That is why I was frustrated with HER use of the term. When the term "Birthrape" used with the possibility forceps insertion or other such things, it becomes much more appropriate, but again I advocate the term "birthrape",in lieu of "rape" having experienced both, I feel entitled to that opinion.
I am also offended when Jenne speaks of herself as a victim, instead of someone who had the chance speak her voice and walk the other way when these threats were presented to her. Most, if not all "rape" and "birthrape" victims are well beyond this point when in said position. My usage of the phrase "uncomfortable situation" was my attempt at shedding some light on this concept.
It is also worth noting that I consider the lady with the pain-killer-free episiotomy to have been assaulted too. A good friend of mine had hers torn, and the stitches completely ripped out just days after delivery by some non OB ER doc when she went to him for bleeding....uggh..that was wicked.
I am not saying that those horror stories aren't out there, cause they are. I simply advocate that hers is not among them. I have heard, experienced, and known of far worse, from women who consider themselves lesser the victim.
Anonymous,
I'm confused. If you are a victim of rape, and have felt that violation of self, why would you go out of your way to tell someone else that their traumatic experience is less valid than your own? When people do things to others without permission, sometimes ignoring pleading and screaming and polite requests, and TAKE someone's choice and autonomy from them, wouldn't you feel a kindred misery?
So, you were raped. Your assault was sexual, in a certain context. The assault upon Jenne's body was ALSO of a sexual nature. You just have to realize that childbirth is meant to be a physiologically normal, spiritual and SEXUAL event. After all, the baby exits from the vagina, which is often the site where hands, surgical tools, and instruments are inserted against the wishes (or without the knowledge or consent) of the laboring woman.
You're protecting your own trauma via definitions. Jenne can't feel raped because YOU were raped, with a PENIS. Well you know what? I respect and hold your space as a trauma survivor. I don't go around saying you were asking for it, or you drank too much. I don't know anything about your situation, but as a fellow woman, I stand by you and YOUR definition of YOUR OWN trauma.
I would never presume to tell you that you could have easily gotten out of that situation. Or that you were embellishing for the sake of your story.
Do you see how disrespectful your attitude is toward another WOMAN'S experience of trauma? You're attempting to diminish her experience into something MERELY uncomfortable and unsatisfactory. Do you do this to women who have been sexually assaulted with no penetration?
"Oh, you weren't REALLY raped. -I- was really raped."
I'm guessing not.
I mean YOU no disrespect, but you've NEVER had any experiences outside your own. Neither have any of us. So, how are we supposed to describe or make ANY comparisons?
You say, "During rape your choice to say no is muffled and taken away."
This was my experience during my birth rape. My ultimate sexual expression of love and creation, my son's birth, was made into a mockery and a rape--when the people around me didn't listen when I said "no" or when I pleaded, or when I screamed it.
So take your sanctimonious attitude and grow up. Its time to respect the experiences of others instead of trying to preserve the impact of your own trauma by arguing semantics with someone who has more than enough reason to understand YOUR experiences better than someone who hasn't been victimized.
--Leslie
(last comment deleted for typos)
The ONLY judge of whether or not an event was traumatic, worthy of note, and makes a person a victim or not is the person who experienced the event.
You cannot tell someone else that they shouldn't define themselves as a victim.
It's just silly.
I thank TopHat and Lady Leslie for responding to Anonymous for me. Understandably, it has been difficult for me to phrase a response that was respectful and defended my experience given how offensive her comments were.
Obviously, Anonymous had a strong emotional response to my use of the word rape which likely obscured for her the fact that I did not call my experience rape. I said it felt like someone was trying to rape me. Leslie described it perfectly how it felt like people were trying to get inside the sexual organs of my body in ways that I was not comfortable with. I guess I could have said "it kind of sort of maybe could have been what it might have felt like if someone had tried rape me." Pretty sure that's not good English though.
Anyway, Anonymous, I hope that felt good for you to get that out. Its an awful feeling that comes from having power taken away from you and being hopeless to take that level of violation away. It something in human nature that when hurt the victim lashes out at who ever is around. I happened to be that person for you.
It is not necessary to redescribe the circumstances of a birthrape, as you would have seen that I have undergone BOTH scenarios: Forceps as well as a Penis. I also clarified that a penis is not the only object with which a woman can be sexually assaulted, going on further to also legitimize the concept of "birthrape". Not saying that one is worse than the other, but simply that they are different. It is from undergoing BOTH horrific events, that I feel the two are vastly different and therefore should be referred to as "rape" and "birthrape" in their proper contexts. Once again, since this is so hard for you to comprehend, at no point did I say that one rape is worse than the other. My opinion is completely valid, unoffensive, and not worthy of such disgust and passive belittlement, (which you ever-so-hypocritically did whilst claiming you could never do). I found that particularly offensive and amusing.
I am sorry for any hurt/disrespect that this may have caused Jenne. I feel that were it not for the one-sided, misguided editorials and twisting of my opinion, I give Jenne the benefit of the doubt that she would take my POV into consideration instead of bashing it without fully opening her mind.
As for calling Jenne a lesser victim, I simply meant to imply that if she faced down that type of a negative situation,she should consider herself a stronger person and a victor, rather than the victim. Something I didn't mean as such a strong offense.
I've never said that I was more of a victim than anyone, as I dont consider myself to be a victim other than that the events took place. I consider myself, instead, a strong woman who has the ability to overcome my circumstance instead of dwelling on the negative. I have chosen to move forward with my life. I had a beautiful child as a result of BOTH experiences, and consider myself thankful for them, instead of upset.
Once again, I ask that you reread my comments without the venomous hatred. You may find that there is legitimacy in my words. You may find that what you thought you read, is not actually written, not even between the lines.
I have the utmost respect for Jenne, who felt enough respect to restrain herself from verbal bashing. I wish that my words hadn't have been so violently twisted that they hurt her in any way. I ask that you no longer attempt to invalidate my opinion by trying to pick it apart. Take my words for what they are, instead of what you contort them in your heads.
In summation: I said that neither rape, nor birthrape is worse than the other, but that from my experiences the two are different. I never said that one was more sexual with the other, or that rape is only with a penis. In fact I made sure to clarify that in my second comment. I never said that Jenne is less than what she is,or her experience was less than what it was, but simply that SHE is MORE.
It is not necessary to redescribe the circumstances of a birthrape, as you would have seen that I have undergone BOTH scenarios: Forceps as well as a Penis. I also clarified that a penis is not the only object with which a woman can be sexually assaulted, going on further to also legitimize the concept of "birthrape". Not saying that one is worse than the other, but simply that they are different. It is from undergoing BOTH horrific events, that I feel the two are vastly different and therefore should be referred to as "rape" and "birthrape" in their proper contexts. Once again, since this is so hard for you to comprehend, at no point did I say that one rape is worse than the other. My opinion is completely valid, unoffensive, and not worthy of such disgust and passive belittlement, (which you ever-so-hypocritically did whilst claiming you could never do). I found that particularly offensive and amusing.
I am sorry for any hurt/disrespect that this may have caused Jenne. I feel that were it not for the one-sided, misguided editorials and twisting of my opinion, I give Jenne the benefit of the doubt that she would take my POV into consideration instead of bashing it without fully opening her mind.
As for calling Jenne a lesser victim, I simply meant to imply that if she faced down that type of a negative situation,she should consider herself a stronger person and a victor, rather than the victim. Something I didn't mean as such a strong offense.
I've never said that I was more of a victim than anyone, as I dont consider myself to be a victim other than that the events took place. I consider myself, instead, a strong woman who has the ability to overcome my circumstance instead of dwelling on the negative. I have chosen to move forward with my life. I had a beautiful child as a result of BOTH experiences, and consider myself thankful for them, instead of upset.
Once again, I ask that you reread my comments without the venomous hatred. You may find that there is legitimacy in my words. You may find that what you thought you read, is not actually written, not even between the lines.
I have the utmost respect for Jenne, who felt enough respect to restrain herself from verbal bashing. I wish that my words hadn't have been so violently twisted that they hurt her in any way. I ask that you no longer attempt to invalidate my opinion by trying to pick it apart. Take my words for what they are, instead of what you contort them in your heads.
In summation: I said that neither rape, nor birthrape is worse than the other, but that from my experiences the two are different. I never said that one was more sexual with the other, or that rape is only with a penis. In fact I made sure to clarify that in my second comment. I never said that Jenne is less than what she is,or her experience was less than what it was, but simply that SHE is MORE.
I agree with anonymous. Although her words are at times poorly and harshly worded, her opinion is as valid as anyone else's. I see that Leslie's comments were actually far more offensive and belittling than any of the others on this page. She openly bit at Anonymous's character instead of her opinion, even once questioning the truth of her experiences with the use of the word "if", particularly disrespectful. She continued to pick apart her statements instead of reading them as a whole, taking them out of context and giving them new, distasteful meaning.
I've been a longtime reader and I feel that, as always, Jenne maintained her respectability and gentility by neglecting to mince words as others have, and instead chose to speak from a place of truth and understanding. Kudos to you.
Anonymous, I didn't get the message from your last comment in your previous comments, so I too misunderstood what you had been meaning to say. Your original messages were hurtful to me and I didn't need the other comments to get to the point of feeling that hurt. Thank you, though, for sharing your experience. It is valuable to me to hear that there are differences between the feelings that come from birthrape and rape from sexual assault.
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